Question

when someone coughs they accidentaly urinate, why is that? what structuers may be involved and is there a way to fix it?

Answer 1

ANSWER

Urinary incontinence is condition in which urine leaks out of bladder, which is involuntary.

Stress incontinence is type of urinary incontinence, that happens when physical movement or activity — such as coughing, laughing, sneezing, running or heavy lifting — puts pressure /stress on bladder, cause urine to leak .

NORMAL MECHANISMS.

Bladder is a muscular balloon like organ, which collects urine from kidney via ureters, it stores urine till voiding. Contraction of bladder muscle cause urine to release through urethra to exit body by relaxing sphincter muscle.

ROLE OF PELVIC FLOOR ( structure responsible)

Pelvic floor muscles (like hammock) includes sling of muscles and facia that supports bladder along with rectum and uterus (in females) .strong pelvic floor responsible for contraction (closing) and relaxation ( opening) of urethral sphincter.

ETIOLOGICAL FACTORS

when pelvic floor muscles get overstretched, damaged or weakened it can leads to incontinence (stress). Causes includes:

• Pregnancy and child birth
• Chronic cough
• Obeisity
• Nerve injury to lower back
• Pelvic surgeries.

COUGH AND STRESS INCONTINENCE.

Coughing cause intra abdominal pressure to rise and relaxes pelvic floor. In people with weakened pelvic floor muscle, this leads to momentarily opening of urethral sphincter causing involuntary expulsion of little amount of urine.

MANAGEMENT

1. Lifestyle modifications: Kegal exercise, weight loss, biofeedbacks, pelvic floor stimulstimulation.
2. Products : Absorbant pads/breifs; urethral inserts, pessaries.
3. Surgeries : Mid urethral sling, bladder neck sling, suspension procedures.